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UM Review Assistant (Remote - California)($22-25/hr)
- Are you an experienced UM Review Assistant looking for a new challenge?
- Do you value care management and quality improvement?
- Are you motivated, energetic, and excited to become part of the Kepro team?
If so, you might be our next new team member!
Who we need:
The Review Assistant will be expected to ensure efficient and accurate completing of TAR forms to streamline the review process and will assist in documenting case information in the EMR for continuous monitoring and tracking of required documents. Maintains working knowledge of internal policies, procedures, and services (both departmental and operational.) Ensures productivity and quality standards are met for required contract deliverables. Prepares all related documents and reports as required in support of the concurrent review process.
Why us?
Kepro is a rapidly growing national quality improvement and care management organization. We work to ensure that over 20 million people receive the right care, at the right time, in the right setting.
People Focused. Mission Driven.
Shape the future of healthcare with us. We are mission driven to improve lives through healthcare quality and clinical expertise.
We do this through our people.
At Kepro, you can do meaningful work that makes a real difference for the lives of individuals across the country. We are an organization that cares deeply about our employees and we provide the training and support to do the best work of your career.
Benefits are a key component of your rewards package at Kepro. These benefits are designed to provide you and your family additional protection, security, and support for both your career and your life away from work. They are comprehensive and fit a variety of needs and situations. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts and more.
What youll do:
- Reviews patient records and compares against submission requirements to determine if all required information is present for the case. Identifies cases where additional non-clinical information is needed.
- Ensure efficient and accurate completing of TAR form.
- Accurate and timely submission of all administrative related documents to appropriate parties.
- Foster positive and professional relationships and act as liaison with internal and external customers to ensure effective working relationships and team building in order to facilitate the review process.
- Responsible for attending training and scheduled meetings and for maintenance and use of current/updated information for case preparation.
- Cross-trains to perform duties of other contracts within the Kepro network to provide a flexible workforce to meet client/consumer needs.
- Other duties as assigned.
The list of accountabilities is not intended to be all-inclusive and may be expanded to include other education- and experience-related duties that management may deem necessary from time to time.
What youll need:
Required Qualifications
- Associate Degree and/or equivalent work experiences related to medical, behavioral, or social/support settings.
- Bachelors Degree preferred
Knowledge, Skills, Abilities
- Knowledge of general review of records, claims, or requests in a healthcare related field.
- Knowledge of HIPAA as well as state and federal regulations as related to behavioral health.
- Knowledge of Medi-Cal billing processes.
- Above average attention to details.
- Medical terminology and/or TAR experience helpful.
- Working knowledge of software with healthcare or insurance application.
- Ability to work in a remote team environment.
- Ability to interpret complex documentation.
- Ability to organize and present case information clearly and accurately.
- Ability to work in a fast-paced environment.
- Excellent verbal and written communication skills essential.
- Computer skills required with Kofax PDF, Microsoft Applications, and proprietary software.
- Strong critical thinking skills necessary.
- Flexibility and good organizational skills needed.
Experience
- 2 years of experience in healthcare or managed healthcare required.
- 3-5 years of experience in administrative or records management.
- Concurrent Review and UM experience helpful.
- QI/Utilization review experience helpful.
Thank You!
We know your time is valuable and we thank you in advance for applying for this position. Due to the high volume of applicants we receive, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Kepro and invite you to apply to future openings that may be of interest. Best of luck in your search!
~ The Kepro Talent Acquisition Team
Mental and Physical Requirements
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations will be made as required by law in an attempt to enable an individual with a disability to perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to sit for prolonged periods of time; key and/or control objects; interact extensively with internal and external customers; occasionally lift and/or move objects weighing up to 10 pounds; and occasionally travel within the state.
EOE AA M/F/Vet/Disability
Kepro is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
Keystone Peer Review Organization, Inc.
